Krackow缝合法与Kessler缝合法治疗跟腱断裂效果的Meta分析

Effectiveness of Krackow- tsuge versus Kessler- tsuge Method for Achilles Tendon Rupture：A Meta -analysis

目的 比较Krackow缝合法与Kessler缝合法治疗跟腱断裂的疗效及安全性.方法 检索CNKI、PubMed、Embase、CENTRAL、CBM、维普和万方数据库,搜集关于Krackow缝合法与Kessler缝合法治疗跟腱断裂的随机对照试验（RCT）,检索时间均为建库至2017年3月.由2位评价员独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析.结果 共纳入7个研究,326例患者.Meta分析结果显示：与Kessler缝合法相比,Krackow缝合法术后满意度更高[RR=8.38,95％CI（3.39,17.61）,P〈0.00001]、术后总的并发症差异无统计学意义[RR=1.04,95％CI（0.71,1.52）,P=0.85];患者术后不同时间段内踝关节功能AOFAS评分差异无统计学意义[RR=0.92,95％CI（0.84,1.01）,P=0.09];患者术后不同时间段内Arner-Lindholm评分差异无统计学意义[RR=0.54,95％CI（0.28,1.05）,P=0.07].结论 与Kessler缝合法相比,Krackow缝合法术后满意度更高,但两种缝合法在术后总的并发症、不同时间段内踝关节功能AOFAS评分及不同时间段内Arner-Lindholm评分方面,临床效果相当.

Objective To systematically compare the efficacy of Krackow- tsuge versus Kesslertsuge in the treatment of Achilles tendon rupture. Methods CNKI, PubMed, Embase, CENTRAL, CBM, VIP and WANFANG da- tabase were searched from establishment to Mar. 2017 for collecting randomized controlled trial（RCT） about Krackow - tsuge versus Kessler - tsuge in the treatment of Achilles tendon ruptare. Two reviewers independently screened litera- ture,extracted data and assessed the risk of bias for included studies. Metaanalysis was performed using RevMan5.3 software. Results 7 RCTs were included （326 patients）. Postoperative satisfaction was higher in Krackow -tsuge method than that in Kessler - tsuge method[ RR = 8.38,95% CI（3.39,17.61 ） ,P 〈 0. 000 01 ]. There was no signifi- cant difference in total complications[ RR = 1.04,95% CI（0. 71,1.52） ,P = 0.85 3. There were no significant differences in AOFAS scores of different time periods [ RR = O. 92,95 % CI （0.84,1.01 ）, P = 0.09 ]. There were no signifi- cant differences in Arner- Lindholm scores of different time periods [ RR = 0. 54,95% CI （0.28,1.05）, P = 0.07 ]. Conclusion Krackow - tsuge method has higher postoperative satisfaction than Kessler - tsuge method. However, there are no significant differences in total complications, AOFAS scores and AOFAS scores of different time periods.